Provider Demographics
NPI:1699158840
Name:OAKLEY, JUSTIN
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:OAKLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30598 HOLTS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:DAGSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19939-3444
Mailing Address - Country:US
Mailing Address - Phone:302-752-8277
Mailing Address - Fax:
Practice Address - Street 1:30598 HOLTS LANDING RD
Practice Address - Street 2:
Practice Address - City:DAGSBORO
Practice Address - State:DE
Practice Address - Zip Code:19939-3444
Practice Address - Country:US
Practice Address - Phone:302-752-8277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC9-00010832278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC9-0001083OtherRESPIRATORY THERAPIST LICENSE NUMBER